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发展中国家的知识转化

Knowledge translation in developing countries.

作者信息

Santesso Nancy, Tugwell Peter

机构信息

Centre for Global Health, Institute of Population Health, University of Ottawa, Ontario, Canada.

出版信息

J Contin Educ Health Prof. 2006 Winter;26(1):87-96. doi: 10.1002/chp.55.

Abstract

There is increasing evidence that the application of knowledge in developing countries is failing. One reason is the woeful shortage of health workers, but as this is redressed, it is also crucial that we have an evidence base of what works to minimize the "know-do gap." The World Health Organization and other international organizations are actively building momentum to promote research to determine effective strategies for knowledge translation (KT). At this time, the evidence base for the effectiveness of those strategies is not definitive in developed countries and is relatively sparse in developing countries. It appears, however, that the effectiveness of these strategies is highly variable and dependent on the setting, and success hinges on whether the strategies have been tailored. A useful framework to provide direction for tailoring interventions is the Ottawa Model of Research Use (OMRU). Underlying OMRU is the principle that success rests with tailoring KT strategies to the salient barriers and supports found within the setting. The model recommends that barriers and supports found in the practice environment or as characteristics of potential adopters and the evidence-based innovation or research evidence be assessed and then the KT strategy tailored and executed. The model also recommends that whether the research has been applied and has resulted in improved health outcomes should be measured. Studies in developing countries, although few, illustrate that the OMRU approach may be a valid method of tackling the challenges of KT strategies to improve health care in developing countries.

摘要

越来越多的证据表明,知识在发展中国家的应用正遭遇失败。一个原因是卫生工作者严重短缺,但随着这一问题得到解决,我们拥有一个关于何种方法能最大限度缩小“知-行差距”的证据基础也至关重要。世界卫生组织和其他国际组织正在积极造势,以推动开展研究,确定有效的知识转化(KT)策略。目前,这些策略有效性的证据基础在发达国家并不明确,在发展中国家则相对稀少。然而,这些策略的有效性似乎差异很大,取决于具体环境,成功与否取决于策略是否经过量身定制。渥太华研究应用模型(OMRU)是一个为量身定制干预措施提供指导的有用框架。OMRU的基本原则是,成功取决于使KT策略适应特定环境中发现的显著障碍和支持因素。该模型建议评估在实践环境中发现的障碍和支持因素,或潜在采用者的特征以及基于证据的创新或研究证据,然后量身定制并实施KT策略。该模型还建议衡量研究是否得到应用以及是否带来了健康结果的改善。发展中国家的研究虽然为数不多,但表明OMRU方法可能是应对KT策略挑战以改善发展中国家医疗保健的有效方法。

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